Walker Matthew R, Zhong Jidan, Waspe Adam C, Piorkowska Karolina, Nguyen Lananh N, Anastakis Dimitri J, Drake James M, Hodaie Mojgan
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Division of Brain, Imaging & Behaviour, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
Front Neurol. 2021 Jul 9;12:673060. doi: 10.3389/fneur.2021.673060. eCollection 2021.
Magnetic resonance-guided focused ultrasound (MRgFUS) is a non-invasive targeted tissue ablation technique that can be applied to the nervous system. Diffusion weighted imaging (DWI) can visualize and evaluate nervous system microstructure. Tractography algorithms can reconstruct fiber bundles which can be used for treatment navigation and diffusion tensor imaging (DTI) metrics permit the quantitative assessment of nerve microstructure . There is a need for imaging tools to aid in the visualization and quantitative assessment of treatment-related nerve changes in MRgFUS. We present a method of peripheral nerve tract reconstruction and use DTI metrics to evaluate the MRgFUS treatment effect. MRgFUS was applied bilaterally to the sciatic nerves in 6 piglets (12 nerves total). T1-weighted and diffusion images were acquired before and after treatment. Tensor-based and constrained spherical deconvolution (CSD) tractography algorithms were used to reconstruct the nerves. DTI metrics of fractional anisotropy (FA), and mean (MD), axial (AD), and radial diffusivities (RD) were measured to assess acute (<1-2 h) treatment effects. Temperature was measured via MR thermometry. Histological data was collected for lesion assessment. The sciatic nerves were successfully reconstructed in all subjects. Tract disruption was observed after treatment using both CSD and tensor models. DTI metrics in the targeted nerve segments showed significantly decreased FA and increased MD, AD, and RD. Transducer output power was positively correlated with lesion volume and temperature and negatively correlated with MD, AD, and RD. No correlations were observed between FA and other measured parameters. DWI and tractography are effective tools for visualizing peripheral nerve segments for targeting in non-invasive surgical methods and for assessing the microstructural changes that occur following MRgFUS treatment.
磁共振引导聚焦超声(MRgFUS)是一种可应用于神经系统的非侵入性靶向组织消融技术。扩散加权成像(DWI)能够可视化并评估神经系统微观结构。纤维束成像算法可重建纤维束,用于治疗导航,而扩散张量成像(DTI)指标则允许对神经微观结构进行定量评估。需要成像工具来辅助可视化和定量评估MRgFUS治疗相关的神经变化。我们提出一种外周神经束重建方法,并使用DTI指标评估MRgFUS治疗效果。对6只仔猪的双侧坐骨神经应用MRgFUS(共12条神经)。在治疗前后采集T1加权图像和扩散图像。使用基于张量和约束球面反卷积(CSD)的纤维束成像算法重建神经。测量分数各向异性(FA)、平均扩散率(MD)、轴向扩散率(AD)和径向扩散率(RD)的DTI指标,以评估急性(<1-2小时)治疗效果。通过磁共振测温测量温度。收集组织学数据用于病变评估。所有受试者的坐骨神经均成功重建。使用CSD和张量模型治疗后均观察到神经束中断。目标神经节段的DTI指标显示FA显著降低,MD、AD和RD升高。换能器输出功率与病变体积和温度呈正相关,与MD、AD和RD呈负相关。未观察到FA与其他测量参数之间的相关性。DWI和纤维束成像对于在非侵入性手术方法中可视化外周神经节段以进行靶向以及评估MRgFUS治疗后发生的微观结构变化是有效的工具。